乳腺基底细胞样癌的病理形态及免疫表型特点

目的探讨乳腺基底细胞样癌的病理形态特点以及多种相关蛋白表达在其病理诊断中的作用。方法应用免疫组化SP法,检测16例乳腺基底细胞样癌CK5/6、CK14、Vimentin、P53及EGFR蛋白表达,对比20例管腔型乳腺癌病理形态,分析乳腺基底细胞样癌的病理形态特征和免疫表型特点。结果乳腺基底细胞样癌大多为浸润性导管癌Ⅲ级(13/16),核分级MBNG多为Ⅲ级(15/16);肿瘤周边推挤式生长,有不同程度的片状坏死及淋巴细胞浸润;瘤细胞排列呈实性巢状、片块状及缎带状结构,肿瘤细胞膜不清晰,细胞质少,核呈圆形或卵圆形,异型性大,核浆比例高,核分裂象多见。16例乳腺基底细胞样癌CK5/6阳性13例,CK14阳性5例,EGFR阳性9例,P53阳性阳性12例,Vi-mentin阳性14例。结论乳腺基底细胞样癌做为一种新的乳腺癌亚型,具有独特的病理形态特征和免疫组化特点,联合检测CK5/6、CK14、Vimentin、P53和EGFR等多项基底细胞蛋白表达,可以用于乳腺基底细胞样癌的病理诊断。

The characteristics of pathologic morphology and immunologic phenotypes in mammary gland basaloid carcinoma

Objective To investigate the diagnostic role of the pathological characteristics and multiple associated protein expression in mammary gland basaloid carcinoma.Methods Protein expression of CK5/6、CK14、Vimentin、P53 and EGFR was examined in 16 cases by immunohistochemical SP method,and pathologic morphology of 20 cases with mammary gland lumens carcinoma was compared to analyze the pathologic traits and immunologic phenotypes of the mammary gland basaloid carcinoma.Results 13 of 16 cases with mammary gland basaloid carcinoma were assessed as grade III of infitrating ductal carcinoma,and 15 of 16 were grade III in MBNG as well;justled growth was found around the turmor with lamellar necrosis in different extents and lympholeukocytic infiltration;neoplastic cell array showed as massive nest,patchy and satin ribbon structure,and the membrane of tumor cells was unsharpness with less cytoplasma,round or oval nucleus,great heteromorphism,higher karyoplasmic ratio and common nuclear mitotic figures.Positive CK5/6 was found in 13 of the 16 cases with mammary gland basaloid carcinoma,5 cases of positive CK14 and 9 cases of positive EGFR and 12 cases of positive p53 and 14 cases of positive Vimentin.Conclusion Mamary gland basaloid carcinoma,a new subtype of mammary gland cancer,has unique pathologic characteristics and immunohistologic features;Combinational examination of multiple basaloid protein expression can be used for pathological diagnosis.